Resolution of tremor fluoxetine-induced in an elderly patient

Aim: To report a possible case of tremor fluoxetine-induced treated as Parkinson’s disease in an elderly female patient noncompliant with the pharmacotherapy, with uncontrolled hypertension and using fluoxetine to treat depression. Presentation of Case: Patient complained of sleepiness in the morning, agitation, anxiety, insomnia and mental confusion. Her greatest concern was about bilateral hand tremors which, in her view became, worse after biperiden was prescribed. Therefore, she stopped taking it. The initial medication was: omeprazole, losartan, biperiden, fluoxetine, atenolol + chlorthalidone, acetylsalicylic acid, atorvastatin and diazepam. Pharmacotherapeutic follow up was performed in order to check the necessity, safety and effectiveness of treatment. Discussion: During the analysis of pharmacotherapy, the patient showed uncontrolled blood pressure and had difficulty complying with the treatment. Thus, in view of the complaints expressed by the patient, our first hypothesis was a possible serotonin syndrome related to fluoxetine use. We proposed a change in the fluoxetine regime and discontinuation of biperiden. As tremors persisted, we suggested the replacement of fluoxetine by sertraline, since a possible tremor fluoxetine-induced could explain the complaint. This approach solved the drug-related problem identified. Conclusion: Tremors reported by the patient was identified as an iatrogenic event related to fluoxetine, which was solved by management of serotonin-reuptake inhibitors.

Resolution of isomeric multi-ruthenated porphyrins by travelling wave ion mobility mass spectrometry

The ability of travelling wave ion mobility mass spectrometry (TWIM-MS) to resolve cationic meta/para and cis/trans isomers of mono-, di-, tri- and tetra-ruthenated supramolecular porphyrins was investigated. All meta isomers were found to be more compact than the para isomers and therefore mixtures of all isomeric pairs could be properly resolved with baseline or close to baseline peak-to-peak resolution (Rp-p). Di-substituted cis/trans isomers were found, however, to present very similar drift times and could not be resolved. N-2 and CO2 were tested as the drift gas, and similar a but considerably better values of R-p and Rp-p were always observed for CO2. Copyright (C) 2012 John Wiley & Sons, Ltd.

Lipase-Catalyzed Kinetic Resolution of (+/-)-Mandelonitrile under Conventional Condition and Microwave Irradiation

The kinetic resolution of (+/-)-mandelonitrile was carried out using lipase from Candida antarctica under conventional condition (orbital shaker) and microwave irradiation in toluene, producing the (S)-mandelonitrile acetate with high selectivity (up to >98% ee, enantiomeric excess). The unreacted (R)-mandelonitrile under microwave irradiation and conventional condition was partially converted into benzaldehyde by spontaneous chemical equilibrium. The (S)-mandelonitrile acetate under microwave irradiation was produced with 92% ee and 35% yield for 8 h of reaction. Conventional transesterification of (+/-)-mandelonitrile in an orbital shaker produced unreacted (R) -mandelonitrile (51% ee) and (S)-mandelonitrile acetate (98% ee) in accordance with Kazlauskas rule for 184 h of reaction.

Exploiting the enzymatic machinery of Arthrobacter atrocyaneus for oxidative kinetic resolution of secondary alcohols

We evaluated Arthrobacter atrocyaneus (R1AF57) as producer of oxidoreductases for oxidative kinetic resolution of racemic secondary alcohols via oxidation reaction. This bacterium was isolated from Amazon soil samples using medium enriched with (RS)-1-(4-methylphenyl)ethanol as a carbon source. The kinetic resolution of several secondary alcohols through enantioselective oxidation mediated by resting cells and growing cells of A. atrocyaneus was efficiently achieved for the most alcohols. In general, it was possible to obtain only the (S)-enantiomer from (RS)-1-arylethanols.

The impact of the medical speciality in primary health-care problem solving in Belo Horizonte, Brazil: homeopaths versus family doctors: a preliminary quantitative study

Introduction: This research project examined influence of the doctors' speciality on primary health care (PHC) problem solving in Belo Horizonte (BH) Brazil, comparing homeopathic with family health doctors (FH), from the management's and the patients' viewpoint. In BH, both FH and homeopathic doctors work in PHC. The index of resolvability (IR) is used to compare resolution of problems by doctors. Methods: The present research compared IR, using official data from the Secretariat of Health and test requests made by the doctors and 482 structured interviews with patients. A total of 217,963 consultations by 14 homeopaths and 67 FH doctors between 1 July 2006 and 30 June 2007 were analysed. Results: The results show significant differences greater problem resolution by homeopaths compared to FH doctors. Conclusion: In BH, the medical speciality, homeopathy or FH, has an impact on problem solving, both from the managers' and the patients' point of view. Homeopaths request fewer tests and have better IR compared with FH doctors. Specialisation in homeopathy is an independent positive factor in problem solving at PHC level in BH, Brazil. Homeopathy (2012) 101, 44-50.

Lipase-catalyzed kinetic resolution of beta-borylated carboxylic esters

The kinetic resolution of chiral beta-borylated carboxylic esters via lipase-catalyzed hydrolysis and transesterification reactions was studied. The enantioselective hydrolysis catalyzed by CAL-B furnished the beta-borylated carboxylic acid with reasonable enantiomeric excess (62% ee), while both methyl and ethyl beta-borylated carboxylic esters were recovered with excellent ee (>99%). Meanwhile, the transesterification reaction of beta-borylated carboxylic esters and several alcohols, catalyzed by CAL-B, only indicated a high selectivity when ethanol and methyl-(beta-pinacolylboronate)-butanoate were used as substrates, which gave ethyl-(beta-pinacolylboronate)-butanoate with >99% ee. (C) 2012 Elsevier Ltd. All rights reserved.

Kinetic resolution of alpha-bromophenylacetamides using quinine or Cinchona alkaloid salts

The kinetic resolution of racemic alpha-bromophenylacetamides 1 was achieved in the presence of benzenethiolate and Cinchona alkaloid salts as phase-transfer catalysts or benzenethiol and quinine, yielding (S)-enantioenriched alpha-sulfanylated products. The observed stereoselection was rationalized on the basis of the best fitting of 1 and the resolving agent in the ternary complexes. (C) 2012 Elsevier Ltd. All rights reserved.

Lipase-catalyzed kinetic resolution of (±)-mandelonitrile under conventional condition and microwave irradiation

The kinetic resolution of (±)-mandelonitrile was carried out using lipase from Candida antarctica under conventional condition (orbital shaker) and microwave irradiation in toluene, producing the (S)-mandelonitrile acetate with high selectivity (up to > 98% ee, enantiomeric excess). The unreacted (R)-mandelonitrile under microwave irradiation and conventional condition was partially converted into benzaldehyde by spontaneous chemical equilibrium. The (S)-mandelonitrile acetate under microwave irradiation was produced with 92% ee and 35% yield for 8 h of reaction. Conventional transesterification of (±)-mandelonitrile in an orbital shaker produced unreacted (R)-mandelonitrile (51% ee) and (S)-mandelonitrile acetate (98% ee) in accordance with Kazlauskas rule for 184 h of reaction.

Dynamic resolution of alpha-substituted dihydrocinnamic aldehydes. A new asymmetric synthesis of pharmaceutically important amine building blocks.

Crystallization-induced diastereoisomer transformation (CIDT) was successfully employed in the enantioselective synthesis of 2-alkyl-3-aryl-propan-1-amines. These products are seen as potentially useful building blocks in the field of asymmetric organic chemistry, notably for pharmaceutically relevant compounds. The procedure was based on a recently reported protocol for deracemization of dihydrocinnamic aldehydes in which enantiomerically enriched 1-(amino(phenyl)methyl)naphthalen-2-ol (Betti base) is employed as a resolving agent. Additionally, fenpropimorph, a biologically active substance which contains the 2-alkyl-3-aryl-propan-1-amine moiety was synthetized, as an attempt to assess the usefulness of the enantiomerically enriched amines.

Editorial reorganization of an alphabetically ordered collection of short stories: analysis of problems and hypothesis of possible solutions

This paper aims to show, analyze and solve the problems related to the translation of the book with meaning-bond alphabetically ordered chapter titles La vita non è in ordine alfabetico, by the Italian writer Andrea Bajani. The procedure is inevitable for a possible translation of the book, and it is necessary to have a preliminary pattern to follow. After translating the whole book, not only is a revision fundamental, but a restructure and reorganization of the collection may be required, hence, what this thesis offers is a scheme to start from, together with an analysis of the possible problems that may arise, and a useful method to find a solution.

Self-identification of problems in the process of listening to English in pre-service interpreters

Questa tesi ha come oggetto di studio i problemi riscontrati nelle trascrizioni di testi orali in lingua inglese prodotte da 39 studenti della laurea magistrale in Interpretazione. Nel Capitolo 1 viene presentato l’ascolto, che viene definito prima da un punto di vista storico, poi analizzato come processo composto da quattro fasi, come sostiene Michael Rost (2011). Il capitolo si conclude con l’ascolto nell’ambito dell’interpretazione. Nel Capitolo 2 viene analizzato in maniera contrastiva l’apprendimento dell’ascolto nella prima e nella seconda lingua. I primi due capitoli forniscono le basi per comprendere il caso di studio. Il Capitolo 3 concerne la metodologia dello studio. Vengono presentati il metodo di analisi delle trascrizioni, la categorizzazione dei problemi riscontrati e il processo di creazione del sistema di analisi utilizzato. Nel Capitolo 4 vengono presentati i dati ottenuti seguendo il metodo esposto nel Capitolo 3. Si presentano i problemi riscontrati, che vengono suddivisi in categorie in base a ciò che può averli causati. Il Capitolo 5 è dedicato alle conclusioni. Qui vengono suggerite possibili strategie mirate ad aiutare gli studenti di Interpretazione a migliorare le proprie capacità di ascolto in lingua inglese. Esta tesis quiere analizar los problemas encontrados en transcripciones de textos orales en inglés hechas por 39 estudiantes del máster en Interpretación. En el Capítulo 1 se presenta la escucha, que se define primero desde una perspectiva histórica, y luego como un proceso formado por cuatro fases, como argumenta Michael Rost (2011). El capítulo se cierra con la escucha en el ámbito de la interpretación. En el Capítulo 2 se analizan de forma contrastiva el aprendizaje de la escucha en la primera y segunda lengua. Los primeros dos capítulos constituyen la base para comprender el caso de estudio. El Capítulo 3 atañe a la metodología del estudio. Se presentan el método de análisis de las transcripciones, la categorización de los problemas encontrados y el proceso de creación del sistema de análisis que se ha empleado. En el Capítulo 4 se proporcionan los datos obtenidos gracias al método presentado en el Capítulo 3. Se presentan los problemas encontrados, que han sido divididos en categorías según qué puede haberlos ocasionado. El Capítulo 5 está dedicado a las conclusiones. Aquí se sugieren posibles estrategias cuyo objetivo es ayudar a los estudiantes de Interpretación a mejorar sus capacidades de escucha en inglés.

Identification of problems in functioning of people with sleep disorders in a clinical setting using the International Classification of Functioning Disability and Health (ICF) Checklist

We conducted an explorative, cross-sectional, multi-centre study in order to identify the most common problems of people with any kind of (primary) sleep disorder in a clinical setting using the International Classification of Functioning, Disability and Health (ICF) as a frame of reference. Data were collected from patients using a structured face-to-face interview of 45-60 min duration. A case record form for health professionals containing the extended ICF Checklist, sociodemographic variables and disease-specific variables was used. The study centres collected data of 99 individuals with sleep disorders. The identified categories include 48 (32%) for body functions, 13 (9%) body structures, 55 (37%) activities and participation and 32 (22%) for environmental factors. 'Sleep functions' (100%) and 'energy and drive functions', respectively, (85%) were the most severely impaired second-level categories of body functions followed by 'attention functions' (78%) and 'temperament and personality functions' (77%). With regard to the component activities and participation, patients felt most restricted in the categories of 'watching' (e.g. TV) (82%), 'recreation and leisure' (75%) and 'carrying out daily routine' (74%). Within the component environmental factors the categories 'support of immediate family', 'health services, systems and policies' and 'products or substances for personal consumption [medication]' were the most important facilitators; 'time-related changes', 'light' and 'climate' were the most important barriers. The study identified a large variety of functional problems reflecting the complexity of sleep disorders. The ICF has the potential to provide a comprehensive framework for the description of functional health in individuals with sleep disorders in a clinical setting.